We have teamed up with Women's Health Nutritionist Georgia Spence to carefully explore the important connection between PCOS (polycystic ovary syndrome) and eating disorders (ED’s) and review the suggested nutritional advice.
Many women living with PCOS struggle with body image, anxiety, and issues surrounding food; which can lead to or exacerbate eating disorders such as anorexia, binge eating, bulimia nervosa or restrictive eating patterns. In this blog, we will discuss how to build a healthier relationship with food and how diet and psychological support can play a crucial role in managing both PCOS and any eating disorder you may face.
Polycystic Ovary Syndrome (PCOS) affects approximately 1 in 8 people, and it can bring a range of challenges; both physical and emotional. Challenges can vary from irregular periods, hormonal imbalances, to body image concerns and mental health struggles. PCOS can also affect how you feel about your body, as well as the relationship you have with food.
This blog aims to explore the connection between PCOS and eating disorders and offer advice on building a healthier relationship with food, focusing on sustainable habits rather than restrictive dieting.
What Is PCOS?
PCOS is a hormonal condition that impacts the ovaries, which can cause:
Irregular periods: This occurs when the ovaries do not release eggs regularly, which can affect fertility.
Excess androgens: High levels of these "male" hormones can lead to symptoms like unwanted facial or body hair and acne.
Polycystic ovaries: Enlarged ovaries containing multiple small fluid-filled sacs around the eggs.
In addition to these symptoms, PCOS can also cause weight gain, insulin resistance, and mood disturbances. These factors can contribute to body image issues and in some cases, disordered eating and eating disorders such as anorexia nervosa, binge eating disorder or bulimia nervosa.
PCOS and Eating Disorders: What’s the Connection?
Research shows that individuals with PCOS are at a higher risk of developing eating disorders. A 2024 study of over 28,000 women with a diagnosis of PCOS found that they were more likely to struggle with eating disorders, such as binge eating and bulimia. This makes sense given the hormonal imbalances, body image concerns, and emotional toll of managing PCOS. These factors can lead to unhealthy eating habits, such as overeating, restriction or disordered patterns of eating.
Recognising the link between PCOS and eating disorders is essential for both individuals and healthcare professionals. A holistic approach that addresses both the physical symptoms of PCOS and the mental health aspects is key to managing the condition effectively.
Building a Healthier Relationship with Food
When it comes to managing PCOS, there is no single diet that will guarantee better health outcomes. Rather than focusing on weight loss or restrictive eating plans, it is important to cultivate a balanced, sustainable approach to food that aligns with your preferences and lifestyle.
Here are some key strategies to help you develop a healthier relationship with food:
Eat Regularly – Consistent, balanced meals throughout the day can help stabilise blood sugar levels and manage insulin resistance. Skipping meals or overly restricting food intake can exacerbate cravings, lead to binge eating, and negatively impact your mental health.
Include fats – Adding protein-rich foods (such as meat, eggs, beans, tofu, or fish) and fats (like olive oil, avocado, and nuts) to your meals can slow down the absorption of carbs, reducing the overall glycaemic load (GL) of your meals. This approach supports better blood sugar control.
Challenge “All or Nothing” Thinking – Restriction can often backfire. Instead of trying to eat perfectly or cut out entire food groups, focus on balance. Allow yourself the freedom to enjoy all kinds of foods without guilt, and try to let go of rigid dieting rules.
Focus on Omega-3s – Including sources of omega-3 fatty acids, such as oily fish (like salmon and mackerel) or plant-based options (chia seeds, flaxseeds, and walnuts), can help reduce inflammation, which is common in PCOS.
Carbohydrates Are Important Too – Carbohydrates play a role in managing PCOS, and it’s important not to cut them out. Instead, focus on low GI (glycemic index) options, which cause your blood sugar to rise more slowly and support better insulin sensitivity. However, it's important not to restrict foods like white bread or sugary treats, as this can lead to unhealthy patterns of overeating or binge eating.
Is Weight Loss Necessary for PCOS?
PCOS can affect people of all sizes, and it’s important to remember that health isn’t defined by a number on the scale. Much of the information available focuses on weight loss, however, for those with disordered eating or eating disorders focusing on weight loss often leads to restrictive eating patterns and can increase stress, which may worsen both PCOS symptoms and your relationship with food. For some people that are underweight that have PCOS, weight loss is not advised and renourishing your body is likely to be recommended.
If weight loss is advised, speak to your health provider about your history of disordered eating or an eating disorder. It’s more beneficial to focus on nourishing your body with a variety of nutrient-dense foods that support your overall well-being. Sustainable habits that make you feel good are far more effective than restrictive dieting.
Can Exercise Help with PCOS?
PCOS guidelines generally recommend aiming for 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity per week, along with strength or resistance training twice weekly. However, if you are struggling with an eating disorder or have an unhealthy relationship with exercise, these guidelines may not be appropriate for you. It's essential to consult with your care team to develop a movement plan that aligns with your personal health and well-being without contributing to stress or disordered behaviours.
Exercise is often recommended to support PCOS, but it’s important to approach movement in a way that feels enjoyable and sustainable for you, without pressure to fit into societal standards of "fitness." While activities like strength/resistance training and cardiovascular exercises, such as HIIT, are commonly suggested for managing PCOS, these isolating activities are not recommended for individuals in recovery from eating disorders. Instead, participating in team sports or group activities can offer a more social and enjoyable way to stay active, taking the focus away from numbers and performance. For those who prefer a gentler approach, or are advised this from their healthcare professionals, activities like yoga can also provide numerous benefits for managing PCOS symptoms.
How to Build a Healthier Relationship with Food
For women with PCOS, particularly those who have experienced disordered eating or an eating disorder, building a healthier relationship with food involves letting go of rigid dietary rules and embracing a flexible, balanced approach. Building a healthy relationship with food starts by recognising that the goal is not perfection but consistency and balance. It’s important to move away from extreme or restrictive diets that fuel anxiety and instead focus on sustainable eating habits that align with your personal preferences. The RAVES model —Regular Eating, Adequate Intake, Variety, Balance, and Eating Socially—offers a helpful structure for re-establishing healthy eating habits. The REAL Food Pyramid encourages incorporating foods that are both nourishing and enjoyable, ensuring that nutrition supports mental and physical well-being while avoiding restrictive diets that can trigger unhealthy behaviours. Both of these models can guide this process by encouraging regular, balanced eating, trying new foods, and eating socially, which can help reduce the stress around food and encourage a more relaxed, sustainable approach to nutrition.
Prioritising self-care—whether through restful sleep, managing stress, or seeking emotional support—will help you manage PCOS and its symptoms without resorting to harmful dieting practices. In cases of PCOS anorexia or binge eating , working with a healthcare professional to develop a personalised, flexible nutrition plan is key to ensuring that you meet your nutritional needs while maintaining a positive mindset around food.
Seeking Support for PCOS
If you believe you have PCOS and have not had a diagnosis please seek support from your GP, who may wish to refer you for further testing at a secondary health location e.g hospital.
Verity is the UK’s leading PCOS charity which offers support to individuals living with PCOS, they also own a company called PCOS UK which aims to educate medical practitioners about PCOS. The Verity webpage: https://www.verity-pcos.org.uk/
If you're struggling with an eating disorder or disordered eating patterns, it's important to seek support from professionals who can help. BEAT, the UK’s leading eating disorder charity, offers vital resources, support, and guidance for those dealing with conditions like anorexia, bulimia, and binge eating disorder. Their helpline and online services can connect you with the help you need, ensuring you receive the right care while managing both PCOS and your relationship with food. To learn more, visit www.beateatingdisorders.org.uk
References
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Cooney, L.G., Gyorfi, K., Sanneh, A., Bui, L.M., Mousa, A., Tay, C.T., Teede, H., Stener-Victorin, E. and Brennan, L., 2024. Increased Prevalence of Binge Eating Disorder and Bulimia Nervosa in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology & Metabolism, p.dgae462.
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